Bursae:

The Bodys Throw Pillows

The other day, my niece asked me
why our bones dont rub together
when we move them.
I explained that we had little
pillows between our bones and
muscles and (sometimes) skin
that stopped any painful rubbing
that might happen.
I was, of course, talking about bursae.
Bursae are little sacs that live between
bones, or bones and muscles, or muscles
and skin, serving to prevent friction at
points of stress throughout the body.
Notice the placement of
bursae on and between
the muscles and bones
of the shoulder joint.
There are four types of bursae:
- Synovial bursae
- Adventitious bursae
- Subcutaneous bursae
- Submuscular bursae
Synovial Bursae
Most of the bursae in the
body are synovial: thin-
walled sacs interposed
between bones, muscles,
and tendons.
The bursa consists of a synovial
membrane containing a capillary
layer of synovial uid, which
provides two lubricated surfaces
that enable freedom of movement.
Synovial bursae tend to be located in your joints,
such as your knees, feet, and shoulders.
Adventitious Bursae
There are also adventitious,
or accidental, bursae. These
occur in soft tissue over bony
prominences, usually because
of repeated pressure or
shearing.
An example of an adventitious
bursae is a bunion, which is a
deformity of the big toe.
The bursa at the metatarsophalangeal
joint becomes swollen, and the head of
the rst metatarsal bone tilts sideways. It
sticks out at its top and creates a
large bump or prominence.
Subcutaneous
Bursae
Subcutaneous bursae lie
between the skin and a bony
process.
For example, the olecranon
bursa sits between the
loose skin of the elbow and
the ulna, acting as a cushion
against friction.
Submuscular Bursae
Submuscular bursae
lie between a muscle
and a bone, or between
adjacent muscles.
The greater
trochanteric bursa sits
between the greater
trochanter of the femur
and the gluteus maximus
(not pictured).
Bursae of the Hip
The iliopsoas bursa is the
largest bursa in the body and
is located on the front of
the hip joint.
The ischiogluteal bursa
is located at the base of
the pelvis, where the bony
prominence is known as the
ischial tuberosity.
Bursae of the Posterior Knee
The medial and lateral
gastrocnemius bursae sit
in between the femoral
condyles and the head of the
gastrocnemius muscle.
The subpopliteal bursa is
located between the lateral
condyle of the femur and the
popliteus muscle.
Bursae of the Leg and Foot
The subcutaneous calcaneal (of medial
malleolus) bursa is located on the medial
part of the tibia.
Located on the calcaneal bone are the
subcutaneous calcaneal bursa and
calcaneal bursa.
The metatarsal bursa is located on
the bottom of the foot, at the base
of the toes. This bursa cushions
the pressure when you stand
on your tippy-toes.
Bursae of the Shoulder
The subcutaneous acromial bursa is located
between the acromion of the scapula and the skin.
The subacromial bursa is located between
the acromion of the scapula and the
supraspinatus muscle.
The subcoracoid bursa is located
between the tendon of the
coracobrachialis and the
subscapularis muscles.
The subtendinous bursa is
located between the neck
of the scapula and the
subscapularis muscle.

The intertubercular
bursa is located
between the biceps
brachiis tendon and the
intertubercular groove of
the humerus.
Bursae of the Hand
The ulnar bursa includes a nger tendon sheath,
which begins at the wrist and ends about half
way up the palm of the hand.
The radial bursa surrounds the
exor sheath of the thumb. It
usually extends from the distal
phalanx to about the volar
wrist crease.
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